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Thursday, December 17, 2009

COPD: What is a blue bloater

In RT school we learn that there are two types of COPD (Chronic Obstructive Pulmonary Disease) patients: emphysema and chronic bronchitis. The non-politically correct term for these two respective diseases are pink puffers and blue bloaters. The question of the day is: What is a blue bloater?

It's probably wrong that we call all chronic bronchitis patients blue bloaters, as it is generally not true. As Deborah Leader writes at About.com writes, ""COPD does not cause edema per se."

That's true. This usually does not occur until the later stages of the disease. As the disease progresses the lungs eventually become so swelled and full of thick secretions that the pressure in the blood vessels in the lungs increases as the right side of the heart works extra hard to pump blood through them.

This results in two things:

1. If the heart works extra hard to pump blood through the lungs for a long period of time this can result in cor pulmonale. This is basically a large heart. The heart is a muscle like any other in the body, and when you work out muscles they grow. It's the same as when a body builder works out his muscles to make them bigger. Only in this case it's not so pretty.

2. This results in pulmonary hypertension. In it's "severe" stages this can lead to feet and leg swelling. Leader notes that this "increased pressure causes damage to the vessels causing blood to back up in the veins of the body. This results in an excess amount of fluid which leaks into the surrounding tissues. When you add gravity to the mix, you now have dependent edema as the fluid pools in your legs, ankles and feet."

Chronic bronchitis can be prevented by stopping smoking and by taking medicines prescribed by a doctor and being compliant with the medicine regime and other therapies he prescribes.

To remedy this complication of end stage COPD patient can put her feet up "higher than your heart and as often as possible will help reduce the edema in your lower extremities.

Diuretics like Lasix are often prescribed to help get rid of some of this fluid. If you're a COPDer and aren't familiar with diuretics, they cause your bladder to absorb fluid from your body and make you pee -- sometimes a lot.

2 comments:

Hi, I stumbled across your blog today and have really enjoyed reading your posts. I just wanted to point out that with cor pulmonale, the inciting factor is increased pulmonary artery pressure which leads to right ventricular enlargement.

In cor pulmonale, the cause originates in the pulmonary vasculature. This differentiates it from the type of heart failure associated with chronic high blood pressure, in which the left ventricle fails, causing increased pulmonary arterial pressure, which may then lead to right ventricular failure.